Does central venous pressure or pulmonary capillary wedge pressure reflect the status of circulating blood volume in patients after extended transthoracic esophagectomy?

Abstract

Purpose

We investigated whether central venous pressure (CVP) or pulmonary capillary wedge pressure (PCWP) can accurately reflect the status of circulating blood volume (CBV) during the perioperative period in adult patients after extended transthoracic esophagectomy.

Methods

In 16 adult patients undergoing esophagectomy, simultaneous measurements of CVP, PCWP, and CBV were made at the following seven points: baseline (before surgery) and at 0, 12, 24, 36, 48, and 60 h after admission to the intensive care unit (ICU). CBV was estimated at the bedside with a pulse-dye densitometry method using indocyanine green. The relationship between CBV and these filling pressures was analyzed by linear regression.

Results

A total of 122 paired observations were made. The mean value of CBV decreased by approximately −20% at admission to the ICU and increased by approximately 24% of baseline at 48 h after surgery. The time course of CVP and PCWP was similar to that of CBV: both decreased at admission to the ICU, then gradually increased, and peaked at 48 h after surgery. However, both pressures remained within normal ranges, and the actual changes from baseline were small. There was no significant relationship between CBV and CVP (r = 0.17, P = 0.07), and between CBV and PCWP (r = 0.03, P = 0.78).

Conclusion

Neither CVP nor PCWP accurately reflected the status of CBV in adult patients after extended transthoracic esophagectomy.